在家中患者对功能进行自我测试,这是一项针对移植患者的前性临床可行性研究
Jonathan S Murray1, Cameron J Williams2, Clare Lendrem2
1Renal Unit, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.
Kidney international reports
|June 7, 2023
概括
移植脏的接受者可以使用手持设备在家进行功能自我测试. 虽然肌素测试显示出良好的一致性,但测试结果与临床测试的一致性较差.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
- 医疗器械 医疗器械
背景情况:
- 长期的健康状况需要定期监测功能.
- 接受移植的接受者需要经常对移植功能进行临床评估.
- 在家进行自我检测为标准诊所访问提供了潜在的替代方案.
研究的目的:
- 评估移植接受者在家中使用手持设备进行功能自我测试的可行性.
- 评估自检家庭结果与标准临床功能测试之间的一致性.
主要方法:
- 一项前性,观察性,单中心可行性研究,涉及15名稳定的脏移植接受者.
- 血液中和肌素水平的比较来自自主进行的毛细血管血液测试 (Abbott i-STAT Alinity) 在家和在临床上由工作人员进行的静脉血液测试 (西门子Advia Chemistry XPT).
- 使用布兰德-阿尔特曼和错误网格分析进行统计分析,以确定家庭和临床试验结果之间的一致性.
主要成果:
- 家庭和临床测试之间的肌素平均差异为2.25μmol/l;所有对都是临床等价的.
- 在家庭和临床测试中的平均差异为0.66 mmol/l; 67.5%的对在临床上相当.
- 患者在家中自行使用设备并不是结果差异的统计学上显著来源,尽管毛细血管血液的生物化学变量影响了差异.
结论:
- 培训脏移植接受者有能力使用手持设备进行家庭功能自我测试是可行的.
- 在家中对肌素进行自我测试,表明与标准临床测试具有良好的分析和临床一致性.
- 虽然在家中对的自我测试显示出较差的一致性,但患者的自我管理并没有对观察到的差异有显著的贡献.
相关概念视频
01:28Kidney Transplant I: Introduction
29
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
29
01:16Kidney Transplant III: Nursing Management
41
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
41
01:26Kidney Transplant II: Surgical Procedure
37
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
37
01:25Chronic Kidney Disease I: Introduction
46
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage kidney disease (ESKD). At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate...
46
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
40
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
40
01:28Chronic Kidney Disease III: Interprofessional Care
50
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
50